Good teaching at the middle grades comes out of a deep understanding of the unique cognitive, physical, social, emotional, and moral needs of young adolescents. Specialized preparation therefore is necessary to help teacher candidates understand how to operationalize the intersection of young adolescent development and the effective pedagogy that addresses their needs. This paper focuses on a qualitative study of experienced middle school teachers who graduated from a middle level preparation program or an elementary or secondary preparation program in terms of how well prepared they felt and feel to meet the widely varied needs of young adolescents. Confidence in preparation leads to high self-efficacy, which is important for perseverance and effectiveness. Graduates of a middle level preparation program reported higher levels of confidence in their preparation to teach young adolescents.